Lung cancer Natural History, Complications and Prognosis: Difference between revisions
No edit summary |
No edit summary |
||
(One intermediate revision by one other user not shown) | |||
Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
The majority of lung cancers present with advanced disease because the symptoms tend to occur later in the course of the disease. | The majority of lung cancers present with advanced [[disease]] because the [[symptoms]] tend to occur later in the course of the [[disease]]. [[Patient|Patients]] experience non-specific [[Symptom|symptoms]] such as [[cough]], [[hemoptysis]], [[dyspnea]], [[chest pain]], [[dysphonia|difficulty speaking]], [[dysphagia|difficulty swallowing]], [[lack of appetite]], [[weight loss]], and [[fatigue]] from 3 weeks to 3 months before seeking medical attention. There are a variety of [[complications]] associated with lung cancer, such as [[pleural effusion]], [[leg weakness]], [[paresthesias]], [[Urinary bladder|bladder]] dysfunction, [[seizures]], [[hemiplegia]], [[cranial nerve palsies]], [[confusion]], [[personality changes]], [[Skeleton|skeletal]] [[pain]], [[pleuritic pain]], [[atelectasis]], and [[bronchopleural fistula]]. The [[prognosis]] of lung cancer is poor if [[Diagnosis|diagnosed]] at the advanced stages. | ||
==Natural History | ==Natural History, Complications, and Prognosis== | ||
==Complications== | === Natural History === | ||
*The majority of lung cancers present with advanced [[disease]] because the [[symptoms]] tend to occur later in the course of the [[disease]].<ref name="leary">{{cite book | last = Leary | first = A | title = Lung cancer a multidisciplinary approach | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Ames, Iowa | year = 2012 | isbn = 9781405180757 }}</ref> | |||
*[[Patient|Patients]] experience non-specific [[Symptom|symptoms]] such as [[cough]], [[hemoptysis]], [[dyspnea]], [[chest pain]], [[dysphonia|difficulty speaking]], [[dysphagia|difficulty swallowing]], [[lack of appetite]], [[weight loss]], and [[fatigue]] from 3 weeks to 3 months before seeking medical attention. | |||
*Depending on the duration of the presence of [[symptoms]], the [[Tumor cell|tumor cells]] may double 20 times.<ref name="leary">{{cite book | last = Leary | first = A | title = Lung cancer a multidisciplinary approach | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Ames, Iowa | year = 2012 | isbn = 9781405180757 }}</ref> | |||
*In more advanced [[disease]], the [[tumor]] may spread to other [[Organ (anatomy)|organs]] such as the [[spinal cord]], [[brain]], and [[bone]]. | |||
*These [[Patient|patients]] may develop [[symptoms]] such as [[leg weakness]], [[paresthesias]], [[Urinary bladder|bladder]] dysfunction, [[seizures]], [[hemiplegia]], [[cranial nerve palsies]], [[confusion]], [[personality changes]], [[Skeleton|skeletal]] [[pain]], and [[pleuritic pain]].<ref name="leary">{{cite book | last = Leary | first = A | title = Lung cancer a multidisciplinary approach | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Ames, Iowa | year = 2012 | isbn = 9781405180757 }}</ref> | |||
*Once the [[cancer]] spreads to the other [[Organ (anatomy)|organs]], it is most likely [[fatal]]. | |||
===Complications=== | |||
'''General Complications''' | '''General Complications''' | ||
The complications associated with | The [[Complication (medicine)|complications]] associated with lung cancer are:<ref name="Jones">{{cite journal | last =Jones | first =DR | coauthors =Detterbeck FC | title =Pancoast tumors of the lung | journal =Current Opinion in Pulmonary Medicine | volume =4 | issue =4 | pages =191–197 | date =Jul 1998 | pmid =10813231 }}</ref><ref name="pmid16476534">{{cite journal |vauthors=Eren S, Karaman A, Okur A |title=The superior vena cava syndrome caused by malignant disease. Imaging with multi-detector row CT |journal=Eur J Radiol |volume=59 |issue=1 |pages=93–103 |year=2006 |pmid=16476534 |doi=10.1016/j.ejrad.2006.01.003 |url=}}</ref> | ||
* [[Breathing difficulties]] | * [[Breathing difficulties]] | ||
:* Lung cancer patients can experience trouble breathing especially when [[tumors]] grow and block the airways. Also, it is possible for fluid to build up in the lungs of the patients which | |||
:* Lung cancer [[Patient|patients]] can experience trouble in [[breathing]] especially when [[tumors]] grow and block the [[Airway|airways]]. Also, it is possible for [[fluid]] to build up in the [[Lung|lungs]] of the [[Patient|patients]] which can negatively affect [[breathing]]. | |||
* [[Pneumonia]] | * [[Pneumonia]] | ||
:* If the cancer grows in the [[airway]], it may obstruct airflow, causing [[dyspnea|breathing difficulties]]. This can lead to accumulation of secretions behind the blockage, predisposing the patient to [[pneumonia]]. | |||
* [[Hemoptysis]] | :* If the [[cancer]] grows in the [[airway]], it may obstruct airflow, causing [[dyspnea|breathing difficulties]]. This can lead to accumulation of [[Secretion|secretions]] behind the blockage, predisposing the [[patient]] to [[pneumonia]]. | ||
:* Occasionally lung cancer can cause bleeding in the airways which | * [[Hemoptysis]] | ||
:* Occasionally, lung cancer can cause [[bleeding]] in the [[Airway|airways]] which can result in [[hemoptysis]]. | |||
* [[Pain]] | * [[Pain]] | ||
:* It is possible that lung cancer will cause pain as well, especially if it spreads to the | |||
:* It is possible that lung cancer will cause [[pain]] as well, especially if it spreads to the [[pleura]] or other areas of the [[Human body|body]], like the [[bones]]. | |||
* [[Pleural effusion]] | * [[Pleural effusion]] | ||
:* Lung cancer can cause fluid to build up in the lungs which can cause breathing difficulties. | |||
:* Lung cancer can cause [[fluid]] to build up in the [[Lung|lungs]] which can cause [[breathing]] difficulties. | |||
* [[Metastasis]] | * [[Metastasis]] | ||
:* In many cases, lung cancer will spread | |||
:* In many cases, lung cancer will spread to other parts of the [[Human body|body]]. Some of the more common places lung cancer [[Metastasis|metastasizes]] to are the [[bones]], [[liver]], [[brain]], and [[adrenal glands]]. | |||
* [[Horner's syndrome]] | * [[Horner's syndrome]] | ||
:* Tumors in the | |||
:*[[Tumor|Tumors]] in the apex of the [[lung]], known as [[Pancoast tumor]]s, may [[Invasive (medical)|invade]] locally into the [[sympathetic nervous system]] leading to [[Horner's syndrome]]. | |||
*[[Superior vena cava syndrome]] | *[[Superior vena cava syndrome]] | ||
**SVCS is a group of symptoms caused by obstruction of the superior vena cava. More than 60% of cases of superior vena cava obstruction are caused by | **[[Superior vena cava syndrome|SVCS]] is a group of [[Symptom|symptoms]] caused by [[obstruction]] of the [[superior vena cava]]. More than 60% of cases of [[superior vena cava]] [[obstruction]] are caused by [[Malignant|malignancies]], especially with a [[tumor]] outside the [[Blood vessel|vessel]] compressing the [[Blood vessel|vessel wall]]. | ||
'''Surgical Complications''' | '''Surgical Complications''' | ||
* [[Bronchopleural fistula]] | * [[Bronchopleural fistula]] | ||
:* It is when air leaks from a [[pneumonectomy]] bronchial stump | |||
:* Approximately 2% of patients that undergo a [[pneumonectomy]] experience this | :* It is when air leaks from a [[pneumonectomy]] [[bronchial]] stump. | ||
:* It will most commonly occur approximately 7 to 10 days after surgery | :* Approximately 2% of the [[patients]] that undergo a [[pneumonectomy]] experience this. | ||
:* It will most commonly occur approximately 7 to 10 days after [[surgery]]. | |||
* [[Hemothorax]] | * [[Hemothorax]] | ||
* [[Atelectasis]] | * [[Atelectasis]] | ||
* [[Sputum]] retention | * [[Sputum]] retention | ||
==Prognosis== | ===Prognosis=== | ||
The prognosis of lung cancer is poor and it depends on the following: | The [[prognosis]] of lung cancer is poor and it depends on the following factors: | ||
''' | * Whether or not the [[tumor]] can be removed by [[surgery]] | ||
*[[Cancer staging|Stage]] of the [[cancer]] | |||
*[[Patient|Patient’s]] general health | |||
* Whether the [[cancer]] has just been [[Diagnosis|diagnosed]] or has recurred | |||
'''Non-small Cell Lung Cancer Survival Rate by Stage'''<ref>Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/prognosis-and-survival/survival-statistics/?region=ab </ref> | |||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 300px" align="center" | {| style="border: 0px; font-size: 90%; margin: 3px; width: 300px" align="center" | ||
| valign="top" | | | valign="top" | | ||
|+ | |+ | ||
! style="background: #4479BA; width: 20px;" | {{fontcolor|#FFF|Stage}} | ! style="background: #4479BA; width: 20px;" |{{fontcolor|#FFF|Stage}} | ||
! style="background: #4479BA; width: 20px;" | {{fontcolor|#FFF|5-year survival rate}} | ! style="background: #4479BA; width: 20px;" |{{fontcolor|#FFF|5-year survival rate}} | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" |IA | |||
! style="padding: 5px 5px; background: #F5F5F5;" |49% | |||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" |IB | |||
! style="padding: 5px 5px; background: #F5F5F5;" |45% | |||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" |IIA | |||
! style="padding: 5px 5px; background: #F5F5F5;" |30% | |||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" |IIB | |||
! style="padding: 5px 5px; background: #F5F5F5;" |31% | |||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" |IIIA | |||
! style="padding: 5px 5px; background: #F5F5F5;" |14% | |||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" |IIIB | |||
! style="padding: 5px 5px; background: #F5F5F5;" |5% | |||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" |IV | |||
! style="padding: 5px 5px; background: #F5F5F5;" |1% | |||
|} | |} | ||
'''Small | '''Small Cell Lung Cancer Survival Rate''' | ||
* To view the prognosis among patients with small cell lung carcinoma, please click [[Small cell carcinoma of the lung natural history, complications and prognosis|'''Here''']] | |||
* To view the [[prognosis]] among [[Patient|patients]] with small cell lung carcinoma, please click [[Small cell carcinoma of the lung natural history, complications and prognosis|'''Here''']]. | |||
==References== | ==References== |
Latest revision as of 19:40, 3 July 2019
Lung cancer Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Lung cancer Natural History, Complications and Prognosis On the Web |
American Roentgen Ray Society Images of Lung cancer Natural History, Complications and Prognosis |
FDA on Lung cancer Natural History, Complications and Prognosis |
CDC on Lung cancer Natural History, Complications and Prognosis |
Lung cancer Natural History, Complications and Prognosis in the news |
Blogs on Lung cancer Natural History, Complications and Prognosis |
Risk calculators and risk factors for Lung cancer Natural History, Complications and Prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Michael Maddaleni, Saarah T. Alkhairy M.D, Dildar Hussain, MBBS [2]
Overview
The majority of lung cancers present with advanced disease because the symptoms tend to occur later in the course of the disease. Patients experience non-specific symptoms such as cough, hemoptysis, dyspnea, chest pain, difficulty speaking, difficulty swallowing, lack of appetite, weight loss, and fatigue from 3 weeks to 3 months before seeking medical attention. There are a variety of complications associated with lung cancer, such as pleural effusion, leg weakness, paresthesias, bladder dysfunction, seizures, hemiplegia, cranial nerve palsies, confusion, personality changes, skeletal pain, pleuritic pain, atelectasis, and bronchopleural fistula. The prognosis of lung cancer is poor if diagnosed at the advanced stages.
Natural History, Complications, and Prognosis
Natural History
- The majority of lung cancers present with advanced disease because the symptoms tend to occur later in the course of the disease.[1]
- Patients experience non-specific symptoms such as cough, hemoptysis, dyspnea, chest pain, difficulty speaking, difficulty swallowing, lack of appetite, weight loss, and fatigue from 3 weeks to 3 months before seeking medical attention.
- Depending on the duration of the presence of symptoms, the tumor cells may double 20 times.[1]
- In more advanced disease, the tumor may spread to other organs such as the spinal cord, brain, and bone.
- These patients may develop symptoms such as leg weakness, paresthesias, bladder dysfunction, seizures, hemiplegia, cranial nerve palsies, confusion, personality changes, skeletal pain, and pleuritic pain.[1]
- Once the cancer spreads to the other organs, it is most likely fatal.
Complications
General Complications
The complications associated with lung cancer are:[2][3]
- If the cancer grows in the airway, it may obstruct airflow, causing breathing difficulties. This can lead to accumulation of secretions behind the blockage, predisposing the patient to pneumonia.
- Occasionally, lung cancer can cause bleeding in the airways which can result in hemoptysis.
- In many cases, lung cancer will spread to other parts of the body. Some of the more common places lung cancer metastasizes to are the bones, liver, brain, and adrenal glands.
- Tumors in the apex of the lung, known as Pancoast tumors, may invade locally into the sympathetic nervous system leading to Horner's syndrome.
- Superior vena cava syndrome
- SVCS is a group of symptoms caused by obstruction of the superior vena cava. More than 60% of cases of superior vena cava obstruction are caused by malignancies, especially with a tumor outside the vessel compressing the vessel wall.
Surgical Complications
- It is when air leaks from a pneumonectomy bronchial stump.
- Approximately 2% of the patients that undergo a pneumonectomy experience this.
- It will most commonly occur approximately 7 to 10 days after surgery.
- Atelectasis
- Sputum retention
Prognosis
The prognosis of lung cancer is poor and it depends on the following factors:
- Whether or not the tumor can be removed by surgery
- Stage of the cancer
- Patient’s general health
- Whether the cancer has just been diagnosed or has recurred
Non-small Cell Lung Cancer Survival Rate by Stage[4]
Stage | 5-year survival rate |
---|---|
IA | 49% |
IB | 45% |
IIA | 30% |
IIB | 31% |
IIIA | 14% |
IIIB | 5% |
IV | 1% |
Small Cell Lung Cancer Survival Rate
References
- ↑ 1.0 1.1 1.2 Leary, A (2012). Lung cancer a multidisciplinary approach. Chichester, West Sussex, UK Ames, Iowa: Wiley-Blackwell. ISBN 9781405180757.
- ↑ Jones, DR (Jul 1998). "Pancoast tumors of the lung". Current Opinion in Pulmonary Medicine. 4 (4): 191–197. PMID 10813231. Unknown parameter
|coauthors=
ignored (help) - ↑ Eren S, Karaman A, Okur A (2006). "The superior vena cava syndrome caused by malignant disease. Imaging with multi-detector row CT". Eur J Radiol. 59 (1): 93–103. doi:10.1016/j.ejrad.2006.01.003. PMID 16476534.
- ↑ Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/prognosis-and-survival/survival-statistics/?region=ab